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Incidence and severity of retinopathy in low birth weight infants monitored by TCPO2
I Yamanouchi1, I Igarashi, E Ouchi
1Okayama National Hospital, Children's Medical Center, Japan.
Insights
Transcutaneous oxygen monitoring (tcPO2) in premature infants appears to prevent severe retinopathy of prematurity (ROP). This study found low ROP incidence and severity, suggesting tcPO2 monitoring is key to eliminating blinding ROP.
Area of Science:
- Ophthalmology
- Neonatology
- Perinatology
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Previous studies highlight the risks associated with oxygen therapy in low birth weight infants (LBWIs).
Purpose of the Study:
- To investigate the incidence and severity of ROP in LBWIs.
- To evaluate the effectiveness of transcutaneous oxygen monitoring (tcPO2) in preventing blinding ROP.
Main Methods:
- A cohort of 561 low birth weight infants (LBWIs) weighing under 2,000g were monitored.
- Transcutaneous oxygen levels (tcPO2) were maintained between 50-80 torr using an Oxymonitor SM 361.
- Ophthalmologic funduscopy was performed until 12 months of age, classifying ROP stages and cicatricial changes.
Main Results:
- 55 cases of active ROP (Stages 1-3) and 27 cases of cicatricial ROP (Grade I) were identified among survivors.
- No infants developed blinding retinopathy.
- Artificial ventilation and oxygen duration did not significantly influence ROP incidence.
Conclusions:
- Transcutaneous oxygen monitoring (tcPO2) appears to be an effective strategy for preventing blinding retinopathy of prematurity.
- The study suggests a lower incidence and severity of ROP compared to previously published data.
- Close monitoring of oxygenation in premature infants is crucial for optimal visual outcomes.
Abstract:
The incidence and severity of retinopathy of prematurity (ROP) were studied in 561 survivors of low birth weight infants (LBWIs) weighing under 2,000g. They were the survivors out of 604 LBWIs admitted to Okayama National Hospital during the five years from January 1981 to December 1985. The tcPO2 of all the LBWIs on the respirator or under oxygen administration was monitored using an Oxymonitor SM 361. The upper limit of tcPO2 was maintained between 50 to 80 torr. The ophthalmologic funduscopy was continued until 12 months of age. The early active stages of ROP were recorded by "the International Classification 1984". The cicatricial change of retina was classified by the criteria of the Joint Committee for the Study of Retrolental Fibroplasia in Japan. In the survivors, 55 cases of active ROP were found. (Stage 1:29 cases, 2:17, 3:9, and 4:0) In the survivors, 27 cases of cicatricial ROP were found, (Grade I:27 cases, II:0, III:0, IV:0) None of them developed blinding retinopathy. Neither the artificial ventilation nor the duration of oxygen administration influenced the incidence of ROP with statistical significance. The incidence and severity of ROP in this study seems to be one of the lowest among those hitherto published. Though our study is not a controlled one, it can be concluded that tcPO2 monitoring eliminates the blinding ROP.